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“Yo-yo dieting” is a no-no for your heart - Weight fluctuations linked to greater heart risks
May 9th, 2017

(WACO, Texas – May 9, 2017) — For people with heart disease, constantly losing and gaining weight like a yo-yo is associated with doubling your risks of heart attack, stroke and even death, according to new research.

“This study shows a powerful association between rapid cycling and increased risk for heart patients,” Timothy Martindale, MD, Providence Family Medicine Clinic, said.  “The body works best with steady, gradual healthy changes that can result in long-term health and prevent heart disease.”

Providence is part of Ascension, the largest nonprofit health system in the U.S. and the world’s largest Catholic health system

Researchers looked at health records of 9,509 people gathered from about five years. All study participants had significant heart disease and were part of a cholesterol-lowering statin drug trial. Those with greater variations in weight had double the risk of a heart attack, stroke or death, when compared with those who weight variations of two pounds or less. 

The study also found increased risk of developing diabetes for those who had greater changes in weight.

More harm than good

Managing weight is key in overall health and keeping heart disease risk factors at bay. While the study does not show cause and effect, the link between weight fluctuation and higher heart disease risks may suggest that losing weight in and of itself doesn’t outweigh the harm done when someone regains the weight.

“Rapid cycling has been shown to encourage weight regain, often more than what was originally lost,” Martindale said. “Increased weight gain can put you at greater risk for diabetes and other harmful consequences.”

Experts say body weight and heart health often go hand-in-hand. According to the American Heart Association, being overweight or obese can lead to high blood pressure, high LDL (“bad” cholesterol) and low HDL (“good” cholesterol), all conditions that put you at greater risk for heart disease and stroke.

The stress of up and down

Weight isn’t the only thing that can go up and down when you yo-yo diet. Known as the stress hormone, cortisol regulates blood pressure and maintains immune function, among other things.

Quick weight changes can stress out your body and lead to excess release of cortisol, Martindale said. In large amounts, it can wreak havoc on your waistline and heart health.

It’s also important to realize the toll yo-yoing can have on your psychological health. Fluctuation in weight often coincides with emotional highs and lows.

“Continuing to lose and then re-gain weight can leave people feeling discouraged, which can lead to low self-esteem and even depression,” Kelly Tarpley, registered dietician and certified diabetes educator at Providence Thyroid, Endocrinology & Diabetes Clinic said. 

Slow and steady wins the race

When it comes to losing weight and keeping it off, quick fixes just don’t work.

“Yo-yo dieting doesn’t build the habits necessary for slow, steady and long-term weight loss,” Martindale said.

Focus on a healthy lifestyle that includes eating lots of plants and whole foods, exercising regularly, moderating stress and maintaining healthy relationships--advice everyone can take to heart.  

For heart patients looking to shed some pounds, Tarpley says many people can safely lose a pound a week until reaching their target weight.

A combination of diet and exercise is a powerful force in weight loss. Watching what you eat helps manage calories and exercise has many benefits that will help you reach and maintain health goals.

“Exercise increases energy, confidence, decisiveness, and a good self-image—all of which can help you stay with a diet plan and remain committed to steady, healthy weight loss,” Martindale said.

You may need to be extra careful if you have heart failure or side effects from medications, so talk to your doctor about what exercise plan is best for you.

Try these tips for making weight loss stick, not the extra pounds:

  • Cut out sugary drinks. Fruit-infused water is a tasty and refreshing alternative.
  • Always use portion control. Limit highly processed foods and opt for lean meats, whole grains, and fruits and vegetables.
  • Set attainable nutrition and exercise goals. A food diary and exercise partner can help keep you on track.  

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About Providence Healthcare Network

In Texas, Ascension operates Providence Healthcare Network and Seton Healthcare Family, which includes Dell Children’s Medical Center of Central Texas and another 120 related clinical facilities that together employ more than 13,000 employees. Across Texas, Ascension provided more than $910 million in community benefit and charity care in fiscal year 2015. Serving Texas for 114 years, Ascension is a faith-based health care organization committed to delivering compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. Ascension is the largest nonprofit health system in the U.S. and the world’s largest Catholic health system, operating 2,500 sites of care – including 141 hospitals and more than 30 senior living facilities – in 24 states and the District of Columbia. Visit www.providence.net. 

Providence offers Dell Children’s Emergency Care - Advanced pediatric emergency care closer to home
May 8th, 2017

(WACO, Texas – May 8, 2017) —Providence is partnering with Dell Children’s Medical Center of Central Texas to offer advanced pediatric-focused emergency care in Waco. 

Infants, children and teens can now visit the ER at Providence and receive high-quality care based on this special relationship with Dell Children’s in Austin. Pediatric experts at Dell Children’s helped develop care guidelines. Doctors at Providence also use telemedicine tools to link directly to Dell Children’s physicians.

Dell Children’s and Providence are part of Ascension, the largest nonprofit health system in the U.S. and the world’s largest Catholic health system. 

The Dell Children’s Difference

Nicholas Steinour, MD, medical director of emergency care at Providence, says his team is eager to offer the community the Dell Children’s experience, closer to home. 

“While Dell Children’s in Austin is Central Texas’ only Pediatric Level I Trauma Center, adding Dell Children’s enhanced best practices to the quality care that Providence is known for, makes Providence a great and convenient option for children who need emergency care here,” Steinour said.

At Providence, patients can expect: 

  • Same great care: Staff follows best practices developed by Dell Children’s  
  • Access to Dell Children’s Physicians: Emergency staff connects to Dell Children’s physicians through telemedicine technology
  • Kid-friendly environment: Dell Children’s Emergency Care patients have a dedicated waiting room and treatment area designed for kids
  • Kid-friendly staff: Providence emergency staff members are trained in Child Life techniques to help reduce stress and anxiety that kids and families can experience during illness, injury or hospitalization

A Tradition of Quality, Compassionate Care

Nearing a decade of service in Central Texas, Dell Children’s has earned a reputation as the region’s pediatric leader, providing children and their families a superb healing experience, Level I trauma, and outcomes that lead to a better future.  

“High quality pediatric emergency care has been a mainstay of Dell Children’s Medical Center and we are excited to be able to bring the same quality of care and services to the Waco community,” said Mark Shen, MD, president, Dell Children’s Health. 

For the Himstedt family, this tradition of specialized care has had a tremendous impact in the care of their daughter, Voa. 

Prenatal scans showed Voa had excess fluid on her brain. Knowing the complications associated with hydrocephaly, the Himstedts chose Dell Children’s to partner with them in the care of their daughter. 

“As a new mom of a baby with specialized needs, I knew I wanted the best for our daughter,” Laura Himstedt said.

Now, the vivacious six-year-old loves gymnastics, art and dress up.  In between being an active tyke, she sees specialists at Dell Children’s who help keep her healthy and active.  

While those visits require travel to Austin, Himstedt says the relationships they have developed with her care team, and the quality of care they receive, make those extra miles worth it. 

“The entire team goes above and beyond to create a personalized experience, making sure all of Voa’s needs are met,” Himstedt said.

Specialized pediatric emergency care closer to home

Himstedt says having Dell Children’s emergency care available closer to home gives her an added level of comfort for the next time Voa needs acute care.

“Going to the ER can be traumatic, for both children and their parents,” Himstedt said.  “What a difference it can make to have a team who is accustomed to working with babies and children, and who are up-to-date on the latest in pediatric care.”

Providence staff is trained on the latest in pediatric protocols to help children get well and back home as quickly as possible. Sometimes, children need more intensive services. Telemedicine tools allow Providence ER staff to directly connect with Dell Children’s emergency medicine doctors and hospitalists, and coordinate seamless transfers when needed. 

“As a regional center of excellence in pediatrics, Dell Children’s provides Central Texans with a family-friendly environment for hospitalizations and surgeries requiring specialty care,” Shen said. 

“Every year we take care of children and families from Waco and are able to assist with lodging and transportation to minimize hardships and allow for a smooth transition.”

More convenient care options

For a quicker, more convenient ER visit, parents can book appointments online atDellChildrensER.com. This feature, intended for minor emergencies, allows patients to be seen within 15 minutes of their arrival time.

Learn more about Pediatric Emergency Care at Dell Children’s.  

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About Providence Healthcare Network

In Texas, Ascension operates Providence Healthcare Network and Seton Healthcare Family, which includes Dell Children’s Medical Center of Central Texas and another 120 related clinical facilities that together employ more than 13,000 employees. Across Texas, Ascension provided more than $910 million in community benefit and charity care in fiscal year 2015. Serving Texas for 114 years, Ascension is a faith-based health care organization committed to delivering compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. Ascension is the largest nonprofit health system in the U.S. and the world’s largest Catholic health system, operating 2,500 sites of care – including 141 hospitals and more than 30 senior living facilities – in 24 states and the District of Columbia. Visit www.providence.net

Survey: One in three U.S. adults may have had a “mini-stroke” - Experts urge immediate action for stroke symptoms
May 3rd, 2017

(WACO, Texas – May 3, 2017) — About 35 percent of people who answered a new survey said they’ve had at least one symptom of a “mini-stroke” – also known as transient ischemic attack (TIA) or warning stroke -- according to new research from the American Stroke Association.

Perhaps more troubling is that only 3 percent of the 2,040 American adults surveyed said they sought medical help as a result of the symptom. Most chose to wait and see, rest or take medicine instead of calling 911, according to the survey.

“TIA is easy to recognize if it acts like a ‘regular stroke,’ with symptoms like speech difficulty, paralysis or body weakness,” said Adam Borowski, MD, interventional neuro radiologist at Providence. Providence is part of Ascension, the largest nonprofit health system in the U.S. and the world’s largest Catholic health system.

”Many TIAs may simply present as a headache, dizziness, confusion or other mild symptoms, that can go undetected,” Borowski said.

Doctors have to perform brain imaging, usually either magnetic resonance imaging (MRI) or computerized tomography (CT) scans, to distinguish whether someone is having a warning stroke or the real thing.

Stroke is the No. 5 cause of death in the U.S. and a leading cause of serious long-term disability.

“Mini-stroke”: A harbinger of future trouble

TIA is a temporary stoppage of blood flow to the brain. It’s caused by a blocked blood vessel or a brain clot. Symptoms tend to last for less than five minutes; on average, they run about a minute long.

The clot may dissolve by itself or just get dislodged. Because TIA doesn’t cause permanent damage, many people tend to dismiss symptoms.

“It is important to recognize the symptoms of a TIA because they act as a warning sign that there may be a bigger, underlying medical problem.” Borowski said. 

In fact, about a third of people who have a TIA end up having a more severe stroke within a year, according to the American Stroke Association. And up to 40 percent of people who have the most common type of stroke (ischemic stroke) say they have had a TIA before.

Earlier treatment means better results

The sooner you are diagnosed, the better your outcomes, too. For example, if you get to the hospital within three hours of having stroke symptoms, and if brain imaging shows that a clot is blocking a blood vessel, a clot-busting drug known as tPA may be used to dissolve the blood clot.

A study from the New England Journal of Medicine shows that people who receive tPA are 30 percent more likely to have no or very little disability three months afterward.

Learn to recognize stroke warning signs

“The only difference between a ‘mini-stroke’ and stroke is how long the symptoms last,” Borowski said. “It’s important to recognize warning signs and act.”

Stroke warning signs include:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of your body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause

Remember “F.A.S.T.” – Face drooping. Arm weakness. Speech difficulty. Time to call 9-1-1.

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About Providence Healthcare Network

In Texas, Ascension operates Providence Healthcare Network and Seton Healthcare Family, which includes Dell Children’s Medical Center of Central Texas and another 120 related clinical facilities that together employ more than 13,000 employees. Across Texas, Ascension provided more than $910 million in community benefit and charity care in fiscal year 2015. Serving Texas for 114 years, Ascension is a faith-based health care organization committed to delivering compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. Ascension is the largest nonprofit health system in the U.S. and the world’s largest Catholic health system, operating 2,500 sites of care – including 141 hospitals and more than 30 senior living facilities – in 24 states and the District of Columbia. Visit www.providence.net. 

Codeine is not for kids
April 26th, 2017

Providence pediatrician supports FDA warning against use of certain cough and pain medications in children

(WACO, Texas– April 26, 2017) — Before you fill that prescription for your child’s pain or nasty cough, take caution, says the Food and Drug Administration (FDA), which has strengthened its warning on prescription cough and pain medications containing codeine or tramadol.

Giving these medications to children under 12 is dangerous due to their link to greater risks of side effects or even death in children, according to the FDA. Codeine is an opioid used to treat cough or pain; tramadol is an opioid painkiller.

“The highest FDA warning on these medicines is absolutely necessary,” said Ronald Coleman Jr., DO, pediatrician at Providence Pediatric Clinic. “Codeine and tramadol carry serious risks, including slowed or difficult breathing and death, which appear to be a greater risk in young children.” Providence is part of Ascension, the largest nonprofit health system in the U.S. and the world’s largest Catholic health system. 

No proven benefit, too many risks

Although the warning is primarily for children under age 12, these prescription medications can also be dangerous to some older kids up to age 18.

“Older children and even teens who are obese or who have obstructive sleep apnea should also stay away from these medicines because they can especially increase the risk of breathing problems in these kids,” Coleman said.

The warning also applies to breastfeeding women because of the risks to their breastfed infants.

Potential side effects include: 

  • Weakness, lethargy
  • Sleepiness, drowsiness
  • Difficulty breathing
  • Decreased gag reflex

A combo of these symptoms may cause a child to stop breathing and, at worst, to die. Signs of difficulty breathing include slow or shallow breathing, noisy breathing, confusion, unusual sleepiness, trouble breastfeeding, or limpness, says the FDA.

Experts say the trouble with codeine and tramadol is that some kids are rapid metabolizers and can end up with toxic levels of the drug in their systems.

What about over-the-counter products?

The FDA warning does not advise against over-the-counter medications containing codeine or tramadol.

Coleman says over-the-counter pain relievers like acetaminophen and ibuprofen are still highly effective when dosed correctly. Carefully check the dosing based on your child’s weight.

“Cough medicines should not be used in children under 4 years unless instructed by a physician,” says Coleman -- guidance that’s consistent with American Academy of Pediatrics (AAP) recommendations.

If you do give your child over-the-counter cough syrup and you’re combining with a fever reducer, that’s another reason to be careful. Many cough meds already contain acetaminophen and ibuprofen, so parents may accidentally overdose their children when using both together.

Safe options for cough and pain

So what choices are left for a parent with a coughing child? Try these remedies for fighting coughs and colds safely:

  • Drink plenty of fluids. Water is best, including warm water.
  • Honey. This is a safe option for children who at least 12 months old, according to the AAP, based on some small studies.[1] Give one-half to 1 teaspoon, either straight or diluted in liquid.
  • Lozenges. Consider these for kids ages 6 and up who do not have a choking risk.
  • Cool mist humidifier. There isn’t conclusive evidence this reduces symptoms or shortens recovery time, but as long as parents use and clean the machine properly, it doesn’t hurt to try.
  • Nasal saline and bulb for congestion. This is an easy way to minimize the discomfort of a runny nose, especially for small kids or infants having a hard time eating or sleeping due to congestion.

Although Grandma might swear by external vapors and rubs, skip these altogether in young kids because many of them have allergic reactions to the treatments.

Signs it’s time to see your pediatrician

Seek medical care immediately if your child has:                    

  • A cough for longer than three weeks.
  • A fever longer than three days.
  • Fast or labored breathing.

Children less than six months old and exposed to whooping cough should see a pediatrician because they are at high risk of contracting the virus, even if they don’t have the characteristic cough.

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About Providence Healthcare Network

In Texas, Ascension operates Providence Healthcare Network and Seton Healthcare Family, which includes Dell Children’s Medical Center of Central Texas and another 120 related clinical facilities that together employ more than 13,000 employees. Across Texas, Ascension provided more than $910 million in community benefit and charity care in fiscal year 2015. Serving Texas for 114 years, Ascension is a faith-based health care organization committed to delivering compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. Ascension is the largest nonprofit health system in the U.S. and the world’s largest Catholic health system, operating 2,500 sites of care – including 141 hospitals and more than 30 senior living facilities – in 24 states and the District of Columbia. Visit www.providence.net.

[1] http://pediatrics.aappublications.org/content/early/2012/08/01/peds.2011-3075

 

Providence Healthcare Network names Interim President
April 17th, 2017

COO Steven Province takes the Providence reins

Steven Province(WACO, Texas – April 17, 2017) Providence Healthcare Network has announced the appointment of Steven Province as Interim President of the hospital, effective May 2, 2017.

“Steven is a passionate leader who is committed as the current chief operating officer to making Providence a place of choice, for both patients and associates,” said Jesús Garza, Seton Healthcare Family President and Chief Executive Officer and leader of Ascension Texas. “His extensive clinical and administrative experience, coupled with a drive to improve access to quality care in Waco, will help further our mission of providing compassionate, personalized care to those we are called to serve,” Garza said.

Providence and Seton are part of Ascension, the nation’s largest non-profit health system.

Province joined the Providence team in 2014 as Senior Vice President for Operations and Chief Operating Officer. A vital leader in improving the health of the Waco community, he will continue to guide Providence on the path the Daughters of Charity began over 112 years ago. 

Province will serve temporarily in the position left open by Brett Esrock, who announced that he will step down as president of Providence Healthcare Network and has accepted an opportunity in Florida. A nationwide search for president has begun, Garza said.

 “In his six years of service to Providence, Brett has made many positive changes that have helped sustain and grow access to health care in the Waco community,” said Garza. “We thank Brett for his leadership and wish him much success in his future endeavors.”

Province holds a Master of Business Administration from Embry Riddle Aeronautical University in Daytona Beach, Florida and a Bachelor of Arts in Pre-Medicine/Biology from California State University in Northridge, California. After serving ten years in the United States Navy as a Naval Supply Officer, Province began his healthcare career as a Pfizer Pharmaceutical representative from 2006-2008. 

In 2008, he began working for Kaiser Permanente in California, where he served as Director of Performance Improvement, Director of Supply Chain Logistics, and Support Services Administrator, prior to coming to Providence. Province is a Lean Six Sigma Black Belt and a fellow of the American College of Healthcare Executives (ACHE).

Diet beverage warning: Think before you drink - Study shows diet drinks linked to tripled risks of stroke, dementia
April 14th, 2017

(WACO, Texas – April 24, 2017) — Reaching for artificially sweetened options can help cut calories, but according to a new study, you may want to rethink that diet drink. 

The study showed that adults who reported drinking one or more artificially sweetened beverages daily had almost a three times higher risk of developing either stroke or dementia, compared to those who drank less than one a week. Results were published in the American Heart Association’s journal Stroke.

“There are many studies that show the negative impact diet soda can have on your overall health,” said Jared Collett, PA-C at Providence Neurosurgical Associates. While the study was not designed to prove cause and effect, the findings are still worth taking note, Collett said. Providence is part of Ascension, the largest nonprofit health system in the U.S. and the world’s largest Catholic health system.

“It’s important to continue looking at available data, and not assume artificially sweetened beverages are a healthier option,” Collette said.

All study participants were part of the ongoing Framingham Heart Study Offspring. Researchers followed 2,888 people over age 45 for the stroke part of the study and 1,484 adults over the age of 60 for the dementia part of the study. Participants answered questions about their diets over the course of seven years. Researchers tracked participants’ stroke and dementia risk for a decade afterward.

The (artificial) sweet truth

Kathy Olansen, MS, RDN, LD, clinical dietician at Providence, says there are both positive and negative claims made about artificial sweeteners, none of which are 100 percent conclusive when talking about most people. Artificial sweeteners can affect people differently, especially when pre-existing illnesses or diseases are in play.

Drinking artificially-sweetened beverages instead of sugar-sweetened beverages can lead to some of the same risk factors linked to the non-diet options, including weight gain. Authors of an editorial published in Stroke say some research shows people who drink artificially sweetened beverages may consume more calories throughout the day.

“The artificial sweeteners hijack the normal reward pathway of eating something sweet. The body doesn’t take in the sugar calories the brain thinks it is getting, and ultimately no signal of satisfaction is sent from the gut to the brain,” Collett said. In response, the brain overcompensates, making you eat more sugar later to make up for the perceived shortage.

This is your brain on fake sweeteners

And when it comes to brain health? The editorial suggests that though the exact mechanism of how artificially sweetened beverages affect the brain isn’t clear, the effect these drinks have on your artery health may play a role.

Collette explains that many of the risk factors for heart disease and stroke are similar to dementia risk factors. As with heart disease, if a brain vessel becomes diseased and doesn’t get the proper blood flow, the brain can be damaged.

The trouble with regular sugar

Are foods and drinks with real sugar any better than artificial sweeteners? Not necessarily.

According to the Centers for Disease Control and Prevention, sugar-sweetened beverages are a prime source of added sugars in the American diet. A 20 oz. bottle can pack in over 200 calories; if you have just one every day, that’s over 1,400 calories each week, with no real nutritional value. 

Less than 10 percent of daily calorie intake should come from added sugars, Olansen said. Added sugars come in different forms. Some are familiar, such as brown, raw and granulated sugar, honey, molasses or pancake syrup.

Other not-so-familiar added sugars include: high-fructose corn syrup, dextrose, sucrose and lactose. The reality is, Olansen said, many people get way beyond the recommended calories from added sugar in food before ever popping that soda pop top.

Too much sugar in your diet can put you at greater risk for weight gain or obesity, type 2 diabetes, heart disease, kidney diseases, non-alcoholic liver disease, and even cavities.

If not this, and not that, then what?

The American Heart Association and American Diabetes Association agree moderate use of artificial sweeteners instead of sugars can help fight weight gain, and help those with diabetes manage sugar and carbohydrate intake. But we need more research to discern the exact benefits and health risks of both diet and non-diet drinks.

If you need to lay off the soda, reach for fruit-infused water, unsweetened tea, low-fat or skim milk instead. Your doctor or a registered dietician can personalize a diet plan to help you meet your specific health and wellness goals.

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About Providence Healthcare Network

In Texas, Ascension operates Providence Healthcare Network and Seton Healthcare Family, which includes Dell Children’s Medical Center of Central Texas and another 120 related clinical facilities that together employ more than 13,000 employees. Across Texas, Ascension provided more than $910 million in community benefit and charity care in fiscal year 2015. Serving Texas for 114 years, Ascension is a faith-based health care organization committed to delivering compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. Ascension is the largest nonprofit health system in the U.S. and the world’s largest Catholic health system, operating 2,500 sites of care – including 141 hospitals and more than 30 senior living facilities – in 24 states and the District of Columbia. Visit www.providence.net. 

Celebrating 30 Years of Love and Humancare
March 16th, 2017

Robert and Patricia Wilcox have a lot of things in common. As they celebrate 30 years of marriage this year, their union exemplifies teamwork. Both are Providence family doctors who have been caring for Waco families since the early 90s. Their bonds to the community in which they work, love and pray continue to strengthen with every passing year.

Teamwork Makes the Dream Work

Partners in practice as well as in life, the Wilcoxes maintain an unflagging commitment to their vocation, their family and their faith. They have three children and their family is active in their church, where both Robert and Patricia teach Sunday school. With so many responsibilities, you may wonder how they find the time to connect and nurture their relationship.

“Being in the same profession gives us a unique understanding of our day-to-day,” Patricia says. “When we collaborate about work, we understand the certain stresses, joys, triumphs and challenges that come with it.”

Being Called to Heal

Robert Wilcox understands that being a physician isn’t an occupation so much as a calling. He regards the work he does as an opportunity to care for each patient as a whole person, respecting their innate humanity. That’s the essence of Humancare.

“There is something very sacred and special about being in a room with a patient -- caring for them, ministering to their medical, physical, mental and spiritual needs,” Wilcox explains.

At Providence, we recognize that partnerships like the ones the Wilcoxes enjoy benefit all of us. The strength and inspiration they derive from their marriage shines outward through the invaluable work they do to care for all who come through their doors.